Ferret Cardiomyopathy or Arrythmia?

Question
Hi

I have a 7 year old ferret called Astro. Recently, I noticed that he started coughing so I took him to the vet. After listening to his heart she diagnosed Cardiomypathy. She prescribed him some medication which she said would take the fluid off of his lungs and ease the coughing. Daily, Astro has:

1/2 an Enacard
1/2 Baytril Antibiotic
1/4 of Fusamine, twice daily.

He seems to be running around as normal, and eating as normal, and is still very playful. I have noticed that if he runs out of Baytril, he starts coughing again, and when he's resting, his breathing is heavy (but not always). When there is heavy breathing it is noticeable only when he is resting.
I did notice, at one point, that he was coughing more than usual. I went to the same vet, who listened to his heart. She said that it seemed to be doing as it should (beating at the normal rate, etc) but seems to be skipping a beat now and again. She has now changed her diagnosis, and has said that Astro's condition is Arrythmia. The vet seems quite frustrated because she can't seem to diagnose the condition as positively as she would like.
This has left me a little confused. I'm not sure what to believe Astro's condition is. When I hear him breathing or coughing it sounds like he has a chest infection! What is this fluid on Astro's lungs? Is it an Infection?
I have done some reading on both cardiomyopathy and Arrythmia, but the symptoms in ferrets seem so similar (which is obviously why my vet can't be too sure of what the condition is!).
We have been asked to take his toys away from him, and not to get him too excited by my regular vet. But we went to see another vet who said that it wouldn't make a difference to his heart whether we took the toys away or not.

Is it possible that he has both Cardiomyopathy and Arrythmia? Or could it be something different entirely?

Hope you can help! :)

Gemma

Answer
Hello Gemma,

First I will summarize cardiomyopathy, even though you probably know plenty about it from your research.   

Cardiomyopathy is a generalized term for a dysfunctional heart and it is a serious condition.  It is unfortunately common in ferrets and thought to have a genetic component.  It happens when the heart can no longer work properly due to the death of cells and the remaining part must compensate and enlarge due to the backup of blood.  Leakage of blood into the lungs/space around the lungs or the abdomen is common due to the buildup of pressure.  This is the reason behind the coughing and appearance of a "fluid-filled belly".

Symptoms include irregular or rapid pulse, fatigue/weakness, swelling of the abdomen, Loss of appetite, and cough.   

Cardiomyopathy can be caused by many things (genetics, viral infection, other organ dysfunction, etc) and your ferret needs further tests to see if it is secondary to another problem.  Often no other causes are found and the disease was there long before the symptoms became apparent.  If your ferret has cardiomyopathy, there is no cure and it is managed with diuretics.  It is a progressive disease.

An arrhythmia is variations in the heart's natural beat.  Some arrhythmias are more serious than others and cardiomypathy can cause arrhythmias.

Information on Cardiomyopathy
http://www.ferretcentral.org/faq/med/cardio.html#williams
http://www.2ndchance.info/cardiomyopathyferret.htm

You are right that his syymptoms do seem consistant with cardiomyopathy, but there are ways to confirm or rule it out by use of x-ray +/- an ECG.  

An x-ray would give a solid diagnosis as well as more information.  I am surprised that your vet did not offer this as an option.  It is easy, fast and extremely useful.  It will determine if there is any fluid building up in/around the lungs or abdomen as well as tell which side is of the heart is enlarged.  If the heart appears normal, it is time to move on to other possibilities such as pheumonia.  

An ECG would be another method to gain more information, specifically on arrthymias.  By looking at the results, a veterinarian can tell which side of the heart is failing and what kind of arrhythmia is seen.  She can then have a solid diagnosis to the problem and treat it accordingly. ECGS are very fast, diagnostic and accurate.  It is a good way to confirm or rule out cardiomyopathy.  

Diuretics, such as encard, will remove this fluid as well as lower the blood pressure and put less strain on a weak heart. It can only treat, not cure cardiomyopathy.  Baytril is an antibiotic, but I am confused as to why it would make the coughing better if it is due to a heart related condition.  My ferret was coughing due to pneumonia and Baytril helped immensely.  I am unsure why it would be given to a ferret in heart failure.   Your vet may have a reason for it though.  

Are you sure you do not mean furosemide?  It is another diuretic.  I could not find much information on furamide other than a supplemental growth stimulant.  If it is not furosemide, I am unsure why it was given.  

Ask your veterinarian to run more diagnostics or seek a second opinion.  Below is a list of ferret friendly vets worldwide (since I am unsure if you live in the USA or not).  Another option is to head for the nearest school of Veterinary Medicine.  These are state of the art facilities with specialists on call at all times.  I would highly recommend this option, having just been in the very same situation myself.    

VETS CANADA:  
* http://www.ferretrescue.ca/start.php
* http://tinylink.com/?TlVyYKa6e0
* http://www.ferrets.org/Veterinarian_Listings.htm   (British Columbia)
* http://www.ferretcentral.org/for-others/db-vets.html

VETS USA:
* http://www.quincyweb.net/quincy/vet.html
* http://ferrethealth.org/vets/
* http://www.ferret-universe.com/vets/vetlist.asp
* http://www.ferretsanctuary.com/vets.shtml
* http://www.ferretcentral.org/for-others/db-vets.html
* http://ferrethealth.org/vets/

VETS  UK & IRELAND:  
* http://homepage.ntlworld.com/ferreter/vetlist.htm

VET INFO/ LIST OF FERRET GROUPS/ CONTACTS IN UK, ITALY, NEW ZEALAND, AUSTRALIA, NETHERLANDS, GERMANY & DENMARK:       
* http://www.ferretcentral.org/for-others/db-overseas.html (scroll down page to find the one you are looking for)

I hope this information is useful.  Please let me know how Astro is doing and whether or not you confirm cardiomyopathy.  If it is indeed something else such as Pneumonia, I can offer some further advice.   My own ferret was sick with it not long ago, and like you I also had difficulty coming to a solid diagnosis (it was finally confirmed with x-ray).  

-Cindy P.